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(Stroke. 2003;34:1693.)
© 2003 American Heart Association, Inc.

Original Contributions

Detection of Hemosiderin Deposition by T2*-Weighted MRI After Subarachnoid Hemorrhage

Toshio Imaizumi, MD, PhD; Masahiko Chiba, MD, PhD; Toshimi Honma, MD Jun Niwa, MD, PhD

From the Department of Neurosurgery, Hakodate Municipal Hospital, Hokkaido, Japan.

Correspondence to Toshio Imaizumi, MD, PhD, Department of Neurosurgery, Hakodate Municipal Hospital, 1-10-1 Minato-cho, Hakodate, Hokkaido, Japan 041-0821. E-mail timaizum{at}d9.dion.ne.ip

Background and Purpose— Subarachnoid hemorrhage (SAH) is very difficult to diagnose several months after its onset. We thus investigated subarachnoid hemosiderin deposition well after SAH by T2*-weighted MRI, a sensitive method for hemosiderin detection.

Methods— To investigate how hemosiderin deposition as confirmed by T2*-weighted MRI contributes to the determination of prior SAH and how the extent of hemosiderin deposition is associated with a number of clinical factors, we retrospectively analyzed 58 patients >3 months after SAH associated with ruptured aneurysms. We also investigated 209 healthy volunteers as controls.

Results— T2*-weighted MRI demonstrated subarachnoid hemosiderin deposition in 72.4% of the SAH patients, whereas no deposition was seen in the healthy volunteer group. The hemosiderin was preferentially deposited in the subarachnoid space near a ruptured aneurysm. Odds ratios (ORs) were estimated from logistic regression analyses correlating hemosiderin deposition with other factors. Age (54 years) (OR, 5.1; 95% CI, 1.03 to 25.0; P=0.046), Fisher grade 3 on initial CT (OR, 8.0; 95% CI, 1.26 to 50.4; P=0.027), and Karnofsky Scale score 80% 6 months after onset of SAH (OR, 12.8; 95% CI, 1.97 to 83.3; P=0.0077) were all found to be independently associated with hemosiderin deposition levels.

Conclusions— T2*-weighted MRI is an effective means of diagnosing prior SAH and may also reveal the location of a ruptured aneurysm. The extent of hemosiderin deposition was significantly associated with several factors, including age, CT findings, and poor prognosis.

Key Words: diagnosis • hemosiderin • magnetic resonance imaging • subarachnoid hemorrhage

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